340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PRX INCORPORATED
STD33009 Lifeline Health, Inc.
Print
Covered Entity Details
Entity Name
Lifeline Health, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33009
Entity Address
501 Federal Highway 1
Lake Park, FL 33403
Grant Number
NH25PS005131
Participating Start Date
7/1/2019
Last Recertification Date
5/26/2022
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
PRX INCORPORATED
Pharmacy Address
PRX PHARMACY
5040 NW 7TH ST SUITE 470
MIAMI, FL 33126
Pharmacy Comments
Contract Details
Approval Date
5/14/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gary G Kogan, Executive Director
(888) 752-2267
Contract Pharmacy Representative
PRX Incorporated
Francisco Urteaga, CEO
(305) 496-9038
Signed By Date
4/9/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session